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Progress update

Progress update. BC Arthroplasty Collaborative Oct. 2006. Models. Model for Accountable Care IHI Quality Improvement Methodology Chronic Disease Management. Model for Accountable Care (MAC).

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Progress update

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  1. Progress update BC Arthroplasty Collaborative Oct. 2006

  2. Models • Model for Accountable Care • IHI Quality Improvement Methodology • Chronic Disease Management

  3. Model for Accountable Care (MAC) Predictable problems delay recovery and result in added morbidity, mortality and functional decline. Anticipation, prevention, screening and timely managementof predictable problems will improve outcomes.

  4. Arthroplasty: Chronic Disease Mgmt Health System CIS Audits for evaluation. Community SMS Workshop Booklet CD ROM DSD Timing Coordination across sites Handoff protocols GP, Exercise, post rehab options, home support DS Clinical pathways & protocols Productive Interactions Informed, Activated Patient Prepared, Proactive Practice Team Improved Outcomes

  5. IHI Rapid Cycle Improvements PDSA Testing out clinical ideas so they can be refined and improved in context. Builds competence, confidence and Will.

  6. Collaborative Vision: Patients in the province of BC will have the same excellent standard of excellent care – where ever they go! • Standardize care – with customization to site • Track and improve clinical outcomes • Streamline systems – improve flow through.

  7. Program Improvement Focus • Optimization: Risk screen & Follow up, coaching/ preparation. Preop CD ROM, Workshop, Booklet • In hospital: OR redesign, focused pathways, orders • Follow up support Post hospital stay: • Follow up phone call - safety net. • Community based rehab, home health.

  8. Aims / Outcome Reports • Optimized for surgery: educated, assessed, problems addressed. • Antibiotic prophylaxis: Optimal timing. • Early mobility: Standing Day 0 • Pain prevention • Nausea prevention • 75% discharged by Day 4. • Home supports in place.

  9. Challenges • Budget cuts. • Patient complexity. • Involving key players eg anesthesiology. • Leaders getting stuck – analysis paralysis.

  10. Keys to success • Leadership: building team capacity, courageous. Action oriented. • Right team: Involvement of key players: RN OT PT, pharmacy, soc w, surgeons, anaesthesiologist. • Commitment and support of operations leaders. • Measuring and reporting progress • Desire and drive to improve.

  11. Screening • In place 1 to 3 months prior to surgery

  12. Optimization Education • In place 1 to 3 months prior to surgery

  13. 4 day Path & Standardized Orders • In place or in process

  14. Follow up phone call or visit post discharge • 24 to 48 hours after discharge.

  15. Thanks to all of you…..

  16. No matter where you go - VCH

  17. in BC FH

  18. patients will receive- NH

  19. the same standard - VIHA

  20. of excellent care! - I H

  21. Keep up the great work. The province is cheering you on!

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